The Challenge
Norton Healthcare’s Narcotics Matrix Committee works continuously to address and define the organization’s prescribing levels and patterns and identify areas for improvement. Committee members and other decision-makers understood that providing clinicians with access to the right data could impact Norton Healthcare’s overall prescribing levels and improve patient outcomes. The committee prioritized integration of actionable data and analytics into clinical workflows to provide prescribers with necessary data to improve clinical decision-making.
Additionally, they sought to make it easier for providers to comply with Kentucky and Indiana mandatory use laws, which require providers to check the PDMP before prescribing or dispensing a controlled substance. Serving patients in a metro area spanning two states often makes it necessary for Norton’s physicians to query both states’ prescription drug monitoring programs (PDMPs) — Kentucky’s KASPER and Indiana’s INSPECT — to view the prescription history for patients who may live in one state and receive treatment and prescriptions in another. Not only that, research has shown that as many as one third of “doctor shoppers” cross state lines to see multiple physicians who will prescribe them narcotic painkillers and other prescription drugs.
Prior to integration, the process to view a patient’s prescription history involved a physician’s delegate searching the KASPER and INSPECT systems separately and loading the results into the patient’s chart — a process that could take as long as 10 minutes.
The Solution
Norton Healthcare utilizes the cloud-based electronic health record (EHR) solution offered by Epic, a longtime partner of Bamboo Health. According to Steven Heilman, M.D., Senior Vice President and Chief Health Innovation Officer with Norton Healthcare, knowing that Bamboo Health had completed numerous successful PDMP integrations for other large health systems on the Epic platform was an important factor in the decision to partner with Bamboo Health.
Joshua T. Honaker, M.D., MBA, FAAP, Chief Medical Administrative Officer, and James T. Jennings MD, Medical Director of Norton Medical Group – Adult Primary Care, serve on Norton Healthcare’s Narcotics Matrix Committee and championed the implementation throughout the organization.
The implementation involved integrating PDMP information and Bamboo Health’s advanced analytics tool directly into the Epic platform at the point of care. The tool provides patient risk analysis and other information in a visually interactive format that helps Norton Healthcare prescribers provide better patient safety and outcomes.
As the first healthcare system in Kentucky to complete a PDMP-EHR integration of this size and scope, the project was not without risk. Judy Holcomb, Associate VP of Patient Information Services, worked closely with the Bamboo Health implementation team and staff at KASPER and the Kentucky Cabinet for Health and Family Services to coordinate testing scenarios and work through state policies to complete the project.
“It was challenging to be the first, but we were able to work through the issues and complete the project successfully,” Holcomb said.
We now have perspective of what goes on outside of our four walls and with doctors outside of our network… The advantage of scoring the risk of overdose provides another level of protection, and we did not have an objective approach to that. It was unwieldy to have someone order the KASPER report and have it scanned into the patient’s chart. That’s where Bamboo Health has been really helpful. It’s now easily visible when I’m seeing a patient.
James T. Jennings MD Medical Director of Norton Medical Group – Adult Primary Care
The Results
Post-integration, Norton Healthcare has charted an increase in physician compliance with mandatory use requirements, and providers have applauded the Bamboo Health technology for its support during telemedicine visits, which have increased considerably in the wake of the COVID-19 crisis.
“We’ve had virtual care for several years now, but since the pandemic started, we ramped it up on a very scalable platform,” Heilman said.
“We’re up to more than 1,500 virtual visits per month with primary care providers and even some specialty providers. In terms of how that affects prescribing, it’s been beneficial having the data visible in workflow while the doctor looks at the chart and the meds, while also interfacing with the patient. They have a complete view with all the systems working together.”
Heilman said the feedback received from Norton providers has been overwhelmingly positive.
“We knew it would be good for the orthopedists, spine surgeons and primary care physicians who treat patients looking for something to treat pain or anxiety. It really helps them with their assessments and reduced a lot of the time and effort and personnel required to get the data they need.”
About Norton Healthcare
For more than 130 years, Norton Healthcare has provided quality healthcare across more than 250 locations, including five Louisville hospitals with 1,837 licensed beds, seven outpatient centers, and 14 immediate care centers. Today, Norton Healthcare is a leader in serving adult and pediatric patients from throughout Greater Louisville, Southern Indiana, the commonwealth of Kentucky and beyond.
About Bamboo Health
Bamboo Health empowers healthcare organizations to improve behavioral and physical health outcomes through the most powerful care collaboration network with Real-Time Care Intelligence™. By providing real-time insights during pivotal care moments, clients are enabled to perform life-improving actions and deliver seamless, high-quality and cost-effective whole-person healthcare. From coast to coast, Bamboo Health partners with five of the six major pharmacy chains, 52 states and territories, 100% of the top 10 best hospitals and more than half of the country’s largest health plans to improve more than 1 billion patient encounters annually.
